Kodi pancytopenia ndi chiyani, ndi zizindikiro ziti, chiani chimayambitsa, ndipo zimatani? Tiyeni tione mafunso awa.
Pancytopenia imatanthauzidwa ngati maulendo ochepa kwambiri mitundu yonse ya maselo a magazi opangidwa ndi mafupa. Izi zimaphatikizapo maselo ofiira a m'magazi, maselo oyera a magazi, ndi mapulogalamu.
Maselo Akumagazi Okhudzidwa Pancytopenia
Mwachindunji, pancytopenia imatanthauza kusowa kwa:
- Maselo ofiira a m'magazi (RBCs): RBC ndi maselo omwe amamanga ndi kutengera mpweya m'magazi a thupi.
- Maselo oyera (WBCs): Pali mitundu yambiri ya maselo oyera a magazi (WBCs) omwe amapitirira kuphwanyidwa kukhala granulocytes (kuphatikizapo neutrophils, eosinophils, ndi basophils), ndi agranulocytes (kuphatikizapo lymphocytes ndi monocytes). Maselo amenewa ali ndi udindo wolimbana ndi matenda pakati pa ntchito zina.
- Mipatale: Platelets ndi omwe amachititsa kuti magazi asamawonongeke.
Kufotokozera Ma Level Lows a Maselo A Magazi
- Mlingo wochepa wa maselo ofiira ofiira umatchedwa kuti magazi . Ndikofunika kuzindikira kuti pali mitundu yosiyana ya kuchepa kwa magazi. Chifukwa chimodzi ndi maselo ofiira a m'magazi, koma chikhoza kuchitika chifukwa cha kutayika magazi, mlingo wotsika wa hemoglobin, kusowa kwa vitamini B12, ndi zina zomwe zimayambitsa.
- Maselo oyera a m'magazi oyera amatchulidwa kuti leukopenia (mukhoza kumva za neutropenia, yomwe imatanthawuza mlingo wochepa wa maselo oyera a mitsempha yoyera otchedwa neutrophils).
- Mapulogalamu apansi amatchedwa thrombocytopenia, monga chitetezo cha mthupi thrombocytopenia , ndi chemotherapy-induced thrombocytopenia .
Kupanga Maselo a Magazi M'matumbo a Mabokosi kapena Hematopoiesis
Maselo amagazi amachokera ku selo limodzi lodziwika bwino mumtambo wa mafupa omwe amadziwika ngati maselo otchedwa hematopoietic stem cell (HSM) kapena maselo ochuluka a pleuripotential (amatanthauza kuti ali ndi "kuthekera" kukhala mitundu yambiri ya maselo.
Maselowa amagawanitsa ndikukhala opambana pang'onopang'ono mu njira yotchedwa hematopoiesis m'maselo onse m'thupi.
Mayesero a Lab
Pancytopenia kawirikawiri imapezeka ndi kuyang'ana magazi okwanira (CBC). Zotsatira ziwonetsa kuchuluka kwa mitundu yonse ya maselo a magazi kuphatikizapo:
- Selo lofiira la magazi limakhala lochepa kuposa maselo 4,2 miliyoni / cc kwa amayi kapena osachepera 4,7 miliyoni maselo / cc mwa amuna (Izi zikhoza kufotokozedwa ndi hemoglobin low level).
- Kuyeretsa kwa magazi kochepa kumadera 4,000 maselo / cc (zachibadwa ndi pakati pa 4,000 ndi 10,000 maselo / cc).
- Pulogalamu yamtengo wapatali yosakwana 150,000 maselo / cc (yachibadwa ndi pakati pa 150,000 ndi 400,000 maselo / cc).
Zimayambitsa
Pancytopenia ikhoza kuyambitsidwa ndi chirichonse chimene chimasokoneza kupanga mapangidwe a magazi mu fupa la fupa kapena kupezeka kwawo m'magazi (monga ngati akugwiritsidwa ntchito mu ntchentche).
Izi zingaphatikizepo kuwonongeka kwa mafupa a mfupa ndi poizoni, kuponderezedwa kwa mafupa, monga mankhwala a chemotherapy, kapena kusintha kwa fupa la mafupa pogwiritsa ntchito maselo ena kumabweretsa chisokonezo cha kupanga maselo a magazi monga momwe zingakhalire ndi khansa zina. Kuwonongedwa kapena kuthetsa kungabwere chifukwa cha kutupa , matenda, kapena zinthu zomwe zimagwira ntchito.
Zambiri mwazimenezi zimapezedwa mtsogolo, koma ochepa ndi obadwa nawo ndipo amakhalapo kuyambira kubadwa.
Pafupifupi 50 peresenti ya nthawiyo si chifukwa chodziŵika-madokotala ena amachitcha kuti "kudziletsa ." Zina mwazifukwa zomwe zingayambitse pancytopenia zikhoza kukhala:
- Kachitidwe kake ka mankhwala a Chemotherapy
- Kugwiritsa ntchito mankhwala osokoneza bongo: Mankhwala osokoneza bongo omwe sali mankhwala a chemotherapy, kuchokera ku maantibayotiki mpaka mankhwala omwe amagwiritsidwa ntchito ku matenda a mtima, atchulidwa kuti ndizo zimayambitsa.
- Matenda monga matenda opatsirana a mononucleosis ndi HIV, komanso matenda opatsirana (sepsis).
- Apulosi ya magazi
- Kuchulukitsa kwapulosi (kugwiritsidwa kwa maselo a magazi mu mpeni kotero kuti sangathe kufika ku thupi lonse).
- Zoizoni ndi mankhwala omwe amawoneka ngati kutsekula kwa arsenic kapena benzene.
- Mankhwala a khansa m'magazi monga fupa la khansa ya m'magazi, lymphoma, myeloma, kapena khansa ya metastatic kuti fupa mafuta.
- Kufalikira kwa zotupa zolimba ku mafupa, makamaka khansa ya m'mawere, kansa ya prostate, khansara yamtundu, kansa ya m'mimba, ndi khansa ya khansa. Ndi mafupa a metastases chizindikiro chofala kwambiri ndi kuchepa kwa magazi m'thupi pambuyo pa thrombocytopenia.
- Myelodysplastic syndrome (chikhalidwe cha "mafupa asanakhalepo khansa")
- Matenda osokoneza bongo monga lupus
- Matenda a mpweya
- Syndromes, monga Fanconi magazi, magazi a Diamond Blackfan .
Zomwe Zimayambitsa Zambiri
Kuphunzira kwa 2014 kunayambitsa zomwe zimachititsa kuti pancytopenia zikhale ndi anthu omwe sanapeze kuti ali ndi vuto. Mwachitsanzo, palibe aliyense wa iwo amene adalandira mankhwala a chemotherapy kapena anali ndi zifukwa zomveka za pancytopenia. Mwa anthu awa:
- Oposa 60 peresenti anali ndi mtundu wina wa khansa yokhudzana ndi magazi. Chofala kwambiri chinali mitsempha yambiri yoopsa ya khansa ya m'magazi , myelodysplasia, yosafunika ya Hodgkin's lymphoma, imitsempha ya khansa yamagazi, komanso khansa ya m'magazi yambiri.
- Mwa iwo omwe analibe khansa yokhudzana ndi magazi monga chifukwa cha pancytopenia yawo, matendawa anaphatikizanso aplastic anemia, megaloblastic anemia, ndi HIV. kuperewera kwa magazi, ndi HIV.
Zizindikiro
Zizindikiro za pancytopenia zingakhale zofooka, kugwidwa, kapena nthenda yotambasula kuphatikizapo zizindikiro zokhudzana ndi kusowa kwa maselo ena enieni. Zizindikiro zina zimaphatikizapo:
- Zizindikiro zokhudzana ndi kuchepa kwa magazi (kuphatikizapo maselo ofiira a m'magazi) kuphatikizapo kupsa, kutopa, kuthamanga kwa mtima, komanso kupuma pang'ono.
- Zizindikiro zokhudzana ndi leukopenia kapena neutropenia (yochepa yoyera yoyera) kuphatikizapo malungo ndi zizindikiro za matenda monga chifuwa kapena kupweteka ndi kukodza
- Zizindikiro zokhudzana ndi thrombocytopenia (mapulogalamu apansi) kuphatikizapo kuphwanya mosavuta, ndi kutaya magazi kwambiri.
Kuzindikira ndi Kufufuza
Mutatha kubwereza ntchito yanu ya labata kuti mutsimikize kuti muli ndi pancytopenia, sitepe yoyamba nthawi zambiri imakhala fupa la mafupa.
Lipoti la mafuta a mafupa a mafupa akhoza kupatsa dokotala zambiri zambiri.
Chithandizo
Cholinga chochiza pancytopenia ndiko kupeza ndi kuchiza chifukwa choyambitsa. Ngati chifukwa chake sichidziwika, kapena ngati chiyembekezeredwa, monga chemotherapy, chithandizochi ndi cholinga chochepetsera zizindikiro zokhudzana ndi kusowa kwa maselo a magazi. Mankhwala ena omwe angagwiritsidwe ntchito ndi awa:
- Mankhwala osokoneza bongo. Chifukwa cha neutropenia ndi zina zimayambitsa, kukula kwa Leukine, Neupogen, kapena Neulasta kungagwiritsidwe ntchito pofuna kupanga mapangidwe a maselo oyera a magazi. Kwa mankhwala ophera tizilombo toyambitsa matenda , amakhalanso ndi mankhwala omwe angaganizidwe.
- Kuika magazi
- Mankhwala osokoneza bongo ngati ali chifukwa cha chikhalidwe chokha.
- Kusakaniza mafupa a mafupa kapena kusuntha maselo .
Kuthamangitsani
Chizindikiro cha pancytopenia chimadalira makamaka chifukwa chake. Tikuyamikira kuti tsopano tili ndi mankhwala monga kupatsirana ndi zinthu zolimbikitsa zomwe zingathandize ndi vuto la maselo enieni a magazi pamene vutoli likuyang'aniridwa ndikuchiritsidwa.
Pansi
Pali zambiri zomwe zingayambitse pancytopenia, koma zonse zimakhala ndi zoopsa. Ndi pancytopenia mitundu yonse ya maselo a magazi imachepetsedwa, ngakhale kuchepa kwa ena kungakhale kovuta kwambiri kuposa ena.
Chitsanzo: Dan anapanga pancytopenia-mlingo wochepa wa maselo ofiira ofiira, maselo oyera a magazi, ndi mapiritsi-atatha mankhwala ake otsiriza a chemotherapy.
> Zotsatira:
> Devitt, K., Lunde, J., ndi M. Lewis. Onset Pancytopenia Yatsopano mwa Anthu Akuluakulu: Kubwereza kwa Zomwe Zikugwirizana ndi Pathologies ndi Zomwe Zimayanjanitsidwa ndi Chipatala ndi Zipatala. Khansa ya m'magazi ndi Lymphoma . 2014. 55 (5): 1099-105.
> Miano, M., ndi C. Dufour. Kusanthula ndi Chithandizo cha Matenda a Plastiki: Kubwereza. International Journal of Hematology . 2015. 101 (6): 527-35.
> Sharma, R., ndi G. Nalepa. Kufufuza ndi Kusamalira Panycytopenia Yosatha. Matenda a Kubwereza . 2016. 37 (3): 101-113.
> Weinzierl, E., ndi D. Arber. Matenda a Marrow Kuwunika Kumayambiriro-Koyambira Pancytopenia. Anthu Odwala Matenda . 2013. 44 (6): 1154-64.
> Weinzierl, E., ndi D. Arber. Kusiyanitsa kwa kusiyana kwake ndi mafupa a mafupa. Kuwunika kwatsopano -kuyamba Pancytopenia. American Journal of Clinical Pathology . 2013. 139 (1): 9-29.